微创改良Bristow-Latarjet术和Bankart修复术治疗复发性肩关节脱位的疗效分析  

Effect analysis of minimally invasive modified Bristow-Latarjet and Bankart prosthesis in the treatment of recurrent dislocation of shoulder joint

作　　者：黄高 徐俊 陈文革 夏正东 Huang Gao;Xu Jun;Chen Wenge;Xia Zhengdong(Department of Joint Surgery,Hubei Minzu University Affiliated Minda Hospital,Enshi 445000,China)

机构地区：[1]湖北民族大学附属民大医院关节外科,恩施445000

出　　处：《中国医师进修杂志》2025年第2期154-159,共6页Chinese Journal of Postgraduates of Medicine

摘　　要：目的比较微创改良Bristow-Latarjet术和Bankart修复术治疗复发性肩关节脱位的临床疗效。方法回顾性选择2019年10月至2022年12月在湖北民族大学附属民大医院诊治的复发性肩关节脱位患者58例,29例患者行微创改良Bristow-Latarjet术(Latarjet组),29例患者行Bankart修复术(Bankart组),比较两组手术基本情况、术后肩关节活动情况、术后Rowe肩关节功能评分(Rowe评分),采用美国肩与肘协会评分系统(ASES)和美国加州大学洛杉矶分校(UCLA)肩关节评分系统对两组患者的肩关节功能恢复情况进行评估,比较两组并发症发生情况。结果Latarjet组手术时间、切口长度、术中出血量、恢复工作时间、复位丢失少于Bankart组[(45.56±12.18)min比(70.35±18.14)min、(4.04±0.82)cm比(6.75±0.95)cm、(61.54±8.88)ml比(86.07±7.53)ml、(13.31±3.21)周比(16.24±3.33)周、(0.97±0.19)mm比(1.24±0.35)mm],差异有统计学意义(P<0.01);Latarjet组外展上举角度、前屈上举角度大于Bankart组[(138.25±10.36)°比(98.15±9.64)°、(140.14±10.43)°比(93.79±8.84)°],差异有统计学意义(P<0.01)。Latarjet组总有效率高于Bankart组[96.55%(28/29)比75.86%(22/29)],差异有统计学意义(χ^(2)=5.22,P=0.022)。Latarjet组术后Rowe评分高于Bankart组[(82.52±15.89)分比(66.78±15.34)分],差异有统计学意义(P<0.01)。Latarjet组术后ASES评分中自我评估部分的疼痛评分、医师评估的累计日常活动评分和UCLA肩关节评分均高于Bankart组[(36.13±8.45)分比(30.17±8.48)分、(40.03±9.54)分比(34.25±8.74)分、(32.08±2.44)分比(27.49±2.56)分],差异有统计学意义(P<0.05)。Latarjet组并发症发生率低于Bankart组[6.90%(2/29)比31.03%(9/29)],差异有统计学意义(χ^(2)=5.50,P=0.019)。结论微创改良Bristow-Latarjet术治疗复发性肩关节脱位,在肩关节功能恢复和术后康复效果方面优于Bankart修复术。Objective To analyze and compare the clinical efficacy of minimally invasive modified Bristow-Latarjet and Bankart prosthesis in the treatment of recurrent shoulder dislocation.Methods A total of 58 patients with recurrent shoulder dislocation treated in the Hubei Minzu University Affiliated Minda Hospital from October 2019 to December 2022 were retrospectively selected,and 29 patients underwent minimally invasive modified Bristow-Latarjet(Latarjet group)and 29 patients underwent Bankart prosthesis(Bankart group).The basic conditions of surgery,postoperative shoulder joint activity,and postoperative Rowe Shoulder Function Score(Rowe score)of the two groups were compared.The shoulder function recovery of the patients was evaluated using the American Shoulder and Elbow Association Scoring(ASES)system and the University of California at Los Angeles(UCLA)shoulder joint scoring system,and the incidence of complications between the two groups were compared.Results The operation time,incision length,intraoperative bleeding volume,recovery working time,and reset loss in the Latarjet group were shorter than those in the Bankart group:(45.56±12.18)min vs.(70.35±18.14)min,(4.04±0.82)cm vs.(6.75±0.95)cm,(61.54±8.88)ml vs.(86.07±7.53)ml,(13.31±3.21)weeks vs.(16.24±3.33)weeks,(0.97±0.19)mm vs.(1.24±0.35)mm,there were statistical differences(P<0.01).The outreach and forward angles in the Latarjet group were higher than those in the Bankart group:(138.25±10.36)°vs.(98.15±9.64)°,(140.14±10.43)°vs.(93.79±8.84)°,there were statistical differences(P<0.01).The total effective rate in the Latarjet group was higher than that in the Bankart group:96.55%(28/29)vs.75.86%(22/29),there was a statistical difference(χ^(2)=5.22,P=0.022).The Rowe scores after operation in the Latarjet group were higher than that in the Bankart group:(82.52±15.89)scores vs.(66.78±15.34)scores,there was a statistical difference(P<0.01).The scores of self-assessment and physician assessment of ASES system and UCLA shoulder scores after operati

关 键 词：肩脱位 微创改良Bristow-Latarjet术 Bankart修复术 治疗结果 对比研究 

分 类 号：R68[医药卫生—骨科学]